National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 706
Submission to the Senate Standing Committee on Community Affairs
Inquiry into the NDIS Future Generations Bill 2026
Introduction
I am a Rural Generalist practising in Terang, Victoria – a town of just under 3,000 people in Southwest Victoria. I hold Fellowship of the Australian College of Rural and Remote Medicine with Advanced Specialised Training in Emergency Medicine. I am also the Lead Victorian Medical Educator for the Victorian ACRRM GP training program and have been invited to be part of the team to develop and deliver the education program for GP diagnosis and prescribing for ADHD in Victoria. I have lived experience as an AuDHD woman without intellectual disability. I also have extensive clinical experience with patients who have significant and complex disabilities, many of whom require 24-hour care.
The problems I have observed with the NDIS have real life consequences to me and my patients. The scheme as it currently operates has significant inefficiencies including an obscene administrative burden and bureaucratic barriers. For example; participants losing access to funding because they are determined to “not need” a service that wasn’t used when in reality they often still desperately need that service but there are no approved NDIS providers in our area. This is particularly frustrating when the service is available through alternative options, but these are not NDIS approved providers and have no interest in going through the bureaucratic burden to become one.
What I did not expect, and what I find deeply alarming, is that the conversation has shifted from fixing the scheme to questioning whether disabled Australians deserve support at all. The proposed changes reflect that shift, and their real-world consequences will be severe. I write to document those consequences as I am already observing them in clinical practice.
- Parental care expectations are placing families in crisis
The proposed changes significantly increase the care burden expected of families and parents of NDIS participants. I am already observing the consequences of this shift in my clinical practice.
I am aware of cases – including among medical colleagues – where parents of high- needs children have been told that if they cannot meet the expected level of care, they risk being reported to child protection services. These are not neglectful parents. These are people who are trying to hold together their professional careers, their own wellbeing and the care of children with profound support needs, often without adequate formal support. In many instances these are single mothers who have fled domestic violence who are also dealing with profound trauma and their own personal battles. In my clinical and personal experience, it is not the men that are left with the
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 706
overwhelming burden of care of these children and many actively turn their back on their responsibilities with little or no consequences.
The parents that I see overwhelmingly carrying the burden of this complex care – mostly women – are smart, capable and resilient people. They are already struggling. The likely outcomes of this bill are unacceptable. At best: highly skilled professionals including primarily female doctors practising in a health system already facing critical workforce shortages will be forced to exit the workforce to become full-time unpaid carers. At worst: the cumulative pressure on individuals already at the limits of their capacity will result in far more serious harm.
The committee should be aware that these are not hypothetical risks. This is already happening and the proposed bill will exponentially exacerbate these risks.
- The hereditary nature of neurodevelopmental conditions makes increased carer expectations structurally incoherent
Autism and ADHD are strongly heritable conditions. A significant proportion of children with severe presentations of these conditions have at least one neurodivergent parent. These parents are not starting from a position of typical neurological and executive functioning capacity. They are frequently managing their own undiagnosed or undertreated conditions while simultaneously caring for a child whose needs may be extreme.
Many of these families have been coping because formal NDIS supports have provided a buffer to allow them to maintain work, financial and emotional stability, and basic household functioning. The proposed changes threaten to remove that buffer and transfer the entire load onto parents who are already operating near their physiological and psychological capacity.
The policy appears to have been designed without any acknowledgement of this dynamic. It will predictably push neurodivergent parents to breaking point then report them to child protective services if they ask for help further pushing them into isolation and predictable devastating outcomes. This is not acceptable.
- Increased carer burden falls disproportionately on women
The evidence on unpaid care in Australia shows that it falls disproportionately on women. Any policy that increases the total amount of unpaid care required in the community will predictably increase the hours women spend outside the paid workforce.
For families with children or adults requiring full-time physical care, this effect is compounded.
The proposed changes will widen the gender pay gap, increase economic dependency among women, and remove women from careers they have worked to build. This dimension of the reform as inherently gender inequitable has not been adequately
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 706
addressed and must be treated as a core impact, not an incidental one. This bill will actively widen the gender pay gap and gender inequity across the board.
- Rural and remote participants face access barriers that urban policy frameworks do not account for
In Terang and the surrounding region, community participation for people with disability requires support in ways that have no equivalent in metropolitan contexts. The nearest cinema, major retail, and most non-GP specialist services are at a minimum 50 kilometres away. Many of my patients with complex needs attend specialist appointments in Melbourne or Geelong requiring a 300-500km round trip requiring logistical support that is already extraordinarily difficult to arrange.
The real cost of community access in rural areas is not well understood in policy discussions. To illustrate: under current NDIS pricing, a rural participant wanting to go to K-Mart or the movies (the nearest ones being 50km away), would require approximately 1.5 hours of support worker time at roughly $70 per hour, plus $50 each way in kilometre-rate transport costs. A single outing costs approximately $400 from a participant’s plan. This is not an extravagance. This is the structural cost of living with disability in a rural community.
The government’s stated goal of reducing average total plan spend from approximately $31,000 to $26,000 per year (~$500/week) to be achieved primarily by cutting social and community participation funding by 30%, must be understood in this rural context. In a rural setting, that budget does not support meaningful community participation. It covers one outing on a weekday.
Regional public transport is not an adequate alternative. Our local V-Line removed the capacity to reserve seats, meaning that disabled and elderly passengers often end up forced to stand or sit on the floor for a 3.5hr journey each way if they wish to travel to Melbourne. Bus replacements, which occur frequently, are often not physically accessible to wheelchair users or those with physical disabilities. I am aware of cases where wheelchair users have been placed in the luggage area of carriages. This is a genuine safety issue, not merely a dignity concern.
There is also a structural problem particular to rural NDIS delivery that the proposed changes do nothing to address. Participants are frequently approved for funding they cannot access because services do not exist locally, or because the only local provider is not a registered NDIS provider. There is not a plethora of choice in rural Australia for these services and increasing the bureaucratic burden suggested in this bill to be an approved provider is going to significantly exacerbate this. Fraud prevention and provider compliance measures in the Bill have merit in principle, but that mandatory electronic claim systems and tighter provider registration requirements will further reduce already-thin rural provider markets.
I also want to document a case that illustrates the intersection of NDIS funding gaps and rural service gaps. I had a patient with a congenital condition who was approaching end of life and completely unable to care for themselves. Because they were under 65 years of age, they were NDIS-funded rather than aged care-funded and therefore could
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 706
not access the local aged care facility. They faced a choice between dying at home under the care of disability support workers doing their best (but not trained nurses and certainly not trained for end-of-life nursing) or moving hours away from their community. This is a structural failure that the proposed changes do not address and will likely worsen.
If community participation supports are reduced or removed, rural participants will not simply manage with less – they will become housebound. The health evidence on social isolation is extensive: it increases mortality, worsens mental health, and accelerates cognitive and physical decline. Reducing these supports causes predictable and significant harm. At the extreme end this is approaching eugenics through neglect.
- Community participation is essential to survival
The proposed changes treat community participation funding as discretionary. This is contradicted by the government’s own record.
A 2020 Productivity Commission Inquiry Report identified loneliness and social isolation as major drivers of suicide and mental illness in Australia. This prompted inquiries in Queensland (2021), the ACT (2023–24), and NSW (2024–25), all of which acknowledged the severe consequences of social isolation and made recommendations to increase social connectedness including investment in community spaces where people gather to connect and build relationships.
These inquiries produced strong cross-party statements about the harm of forced isolation such as the links to cognitive decline, loss of self-worth, mental illness, and the fundamental human need for face-to-face social interaction.
The same logic applies to disabled Australians being denied the support needed to participate in community life. Social connection, meaningful activity, and community membership are determinants of physical and mental health. They are also rights enshrined in the UN Convention on the Rights of Persons with Disabilities, to which Australia is a signatory.
It is not coherent to simultaneously acknowledge the devastating health consequences of social isolation and then cut the supports that allow some of Australia’s most isolated citizens to leave their homes and engage with their communities. This is blatant ableism.
- Cutting NDIS supports is not economically rational
The framing of NDIS expenditure as a fiscal burden misrepresents how the scheme functions economically. NDIS investment is not expenditure that leaves the economy.
Per Capita’s 2021 report False Economy, produced in collaboration with National Disability Services, found that the NDIS generates a conservative economic multiplier of $2.25 for every dollar invested. In 2020–21 alone, the scheme contributed an estimated $52.4 billion to the Australian economy. The scheme directly employs over
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 706
270,000 workers across more than 20 occupational categories, with further tens of thousands employed indirectly.
The same modelling finds that for every $1 billion by which the NDIS is underfunded, approximately 10,200 jobs are lost and $2.25 billion in economic activity disappears. Cutting NDIS supports does not save money in any meaningful sense. Instead, it shifts costs onto unpaid carers, state health and emergency systems, and the broader welfare system, while simultaneously destroying employment.
There is a further dimension that does not appear to have been appreciated. The economic cost of removing paid workers from the equation is inseparable from the question of who absorbs that labour. When a support worker is employed to assist a participant, two economic outcomes occur simultaneously: a worker earns a wage and contributes to local economic activity, and a family carer – usually a woman – retains the capacity to remain in paid work. Remove the support worker, and you remove both of those contributions. This is just going to transfer cost disproportionately to women as invisible and unpaid labour that doesn’t appear on the NDIS budget line.
The proposed changes are projected to save $15 billion over four years by removing approximately 160,000 people from the NDIS and cutting social and community participation funding. That doesn’t include the new applicants who will be denied access to essential supports. It is worth noting that a 25% tax on offshore gas exports is estimated by the Australia Institute to raise approximately $17 billion annually. The committee may wish to consider whether the fiscal trade-offs being made reflect the full range of options available.
Any honest economic analysis of these changes must account for the full ledger: lost workforce participation, increased emergency health and welfare expenditure, destruction of regional employment, and the transfer of uncosted labour burden onto carers.
- The underlying assumption driving these changes must be named and rejected
There is an assumption embedded in the public and political debate around the NDIS that deserves to be stated directly: that a person’s value derives from their economic productivity, and that people who cannot work are therefore less deserving of public investment in their lives.
This assumption is wrong. It is also dangerous. The history of what happens when societies systematically treat disabled people as burdens rather than as people with inherent rights is documented, and its endpoint is severe. Australia has ratified the International Covenant on Civil and Political Rights and the UN Convention on the Rights of Persons with Disabilities, both of which recognise the inherent dignity of all people. The proposed changes are inconsistent with those commitments.
It is also worth noting that the Australia’s Disability Discrimination Commissioner Rosemary Kayess and National Children’s Rights Commissioner Deb Tsorbaris were calling for urgent government action only a few months ago following the deaths of a
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 706
family in Western Australia including calling for a coronial inquest and urgent implementation of the Disability Royal Commission’s recommendations.
The changes in the NDIS amendment bill 2026 appear to be in direct contradiction to many of the 222 recommendations including:
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Community participation. The Royal Commission explicitly recommended dismantling barriers to inclusion and community participation. The Bill cuts social and community participation funding by 30%. These are in direct opposition.
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Remote and rural access. The Royal Commission specifically found there are barriers to accessing the NDIS in remote areas of Australia and that significant change is required to remove them. The Bill’s tighter eligibility and provider compliance requirements will worsen, not improve, rural access.
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Rights Act. The Royal Commission recommended a Disability Rights Act. The government has not accepted this. The Bill increases ministerial power to define and limit supports which is moving in the opposite direction to rights-based protection.
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Safeguarding. The Royal Commission recommended expanding safeguarding to protect participants. The Bill’s safeguarding provisions focus on provider conduct, which is consistent but the coercive use of child protection threats against carers is already starting to happen and is precisely the kind of systemic abuse the Royal Commission was concerned about. The Bill contains no protections against it.
I urge the committee to examine not just the technical provisions of this legislation, but the values embedded in it. The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability heard from almost 10,000 people over four and a half years. They were promised that their evidence would drive change. This Bill cuts community participation, tightens access, and increases carer burden in direct contradiction of the Royal Commission’s core recommendations on inclusion, independence, and removing barriers to NDIS access in rural and remote communities. The committee should require the government to explain, recommendation by recommendation, how this Bill is consistent with the process it asked disabled Australians to trust.
Recommendations
• Do not proceed with changes that increase informal carer obligations without commensurate funded support, crisis pathways, and carer health protections. • Commission an independent gender impact assessment of the proposed carer expectation changes before any legislation proceeds. • Require a rural and remote impact assessment that reflects actual geographic, transport, and service access conditions in communities like Terang not metropolitan assumptions applied uniformly.
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 706
• Treat community participation supports as a health and human rights imperative, consistent with Australia’s existing commitments under the UNCRPD and the government’s own findings on social isolation. • Establish clear protections against the use of child protection referral threats under the guise of the adjusted definition of “parental responsibility” to coerce parents of NDIS participants into care arrangements they cannot safely sustain. • Address the structural rural service gap including the approved-but- inaccessible-funding problem rather than simply reducing funding. • Conduct a full economic impact assessment that accounts for unpaid carer burden, workforce participation effects, and regional employment rather than focusing only on NDIS expenditure. • Require the government to explain, recommendation by recommendation, how this Bill is consistent with the recommendations of the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. Where it is not consistent, require them to explain why they are choosing to act in direct contradiction to those recommendations.
I am available to provide further evidence to the committee if that would be of assistance.
Dr Stefanie Hammond FACRRM Rural Generalist, Terang, Victoria Lived experience AuDHD woman May 2026